Injury
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This multicentre case-control study compares Vancouver Classification System (VCS) grade and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) fracture type in interprosthetic femoral fractures (IPFFs) between primary total hip arthroplasty (THA) and ipsilateral total knee arthroplasty (TKA) to periprosthetic femoral fracture (PFF) without ipsilateral TKA. ⋯ The presence of an ipsilateral TKA affects the location of PFF with more fractures occurring distal to the stem. A greater proportion of bending type fractures occurred when an ipsilateral TKA was present. These unstable fractures often require more complex surgery.
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Randomized Controlled Trial
The effect of a controlled mandible position mouthguard on upper body strength and power in trained rugby athletes - A randomized within subject study.
It is widely accepted that mouthguards are effective for injury protection in sports. However, findings on the effects of mouthguards in strength and power production remains controversial. Therefore, the aim of this study was to determine whether controlled-mandible position mouthguards influence strength and power production in well trained athletes. ⋯ Controlled mouthguards enhance peak force and peak acceleration in the ballistic bench press exercise without negatively affecting any other measure assessed in this study. We speculate that this is possibly due to an increased stability of temporomandibular joint.
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Femoral neck fractures in the young patient present a unique challenge. Most surgeons managing these injuries prefer a fixed angle implant, however these devices are fraught with problems. A dynamic hip screw (DHS) is one such fixed angle device that risks malreduction through rotational torque during screw insertion. To avoid this risk some surgeons utilize a dynamic helical hip system (DHHS), however little is known about the complication profile of this device. We hypothesized that the complication rate between these two devices would be similar. ⋯ This study demonstrates a high risk of complication when managing young femoral neck fractures in line with prior literature. The major complication rate of non-union requiring osteotomy or fixation failure resulting in THA was no different between the two groups, but the rate of shortening was greater the DHS group. This data suggests the DHHS may be a suitable device to manage the young femoral neck fracture and without increased risk of complication.
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Observational Study
Predicting mortality for critically ill burns patients, using the Abbreviated Burn Severity Index and Simplified Acute Physiology Score 3.
Reviewing the profile of patients admitted at the Burns Intensive Care Unit at São Paulo Hospital - UNIFESP, as well as the available literature, it becomes evident the need for tools able to predict those patients' outcomes. Distinct score models are used in different health centers, not only as prognostic models, but also as research and quality control tools. Amongst these prognostic scores, there are two strands, the burns specific scores - which consider the injury's characteristics - and the general critical patient's scores. ⋯ The study evidences that SAPS 3 score, frequently used at general Intensive Care Units, has a similar performance to ABSI score, which is specific for burns populations. ABSI score is easier to implement, as it is simpler and able to show instant results.
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This study aimed to introduce the circle drawing method for the evaluation of marginal impaction associated with posterior malleolar fractures (PMFs) on computed tomography (CT) images and evaluate the marginal impaction based on PMF patterns (Bartonícek classification) in rotational ankle fractures. ⋯ The marginal impaction associated with PMFs is often observed in rotational ankle fractures, particularly in small posterolateral and posteromedial extended fractures.